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Click or tap here to enter text.P.O. BOX 2415 EDMONTON, AB T5J 2S5 FAX: 7804275863 18006611993 C851 PSYCHOLOGY SERVICES Counselling Initial ReportWORKER DETAILS Legal Gender ? Female ? Male ? X WCB
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How to fill out psychology treatment extension request

01
To fill out a psychology treatment extension request, follow these steps:
02
Begin by providing your personal information, including your name, contact details, and identification number.
03
Next, specify the details of your current treatment plan, such as the name of your therapist, the duration of the treatment, and the type of therapy being provided.
04
Describe the reasons why you require an extension for your psychology treatment. Explain any changes or challenges you have encountered during the treatment process.
05
If applicable, attach any relevant medical documents or reports that support your request for an extension.
06
Provide the desired length of the extension period and state the date from which the extension should start.
07
Finally, sign and date the request form and submit it to the appropriate authority or department.

Who needs psychology treatment extension request?

01
Anyone who is undergoing psychology treatment and requires an extension beyond the initially agreed upon duration may need to fill out a psychology treatment extension request. This could include individuals with mental health conditions, individuals seeking therapy for personal development or relationship issues, and those recovering from traumatic experiences or dealing with stress-related disorders. It is important to consult with your therapist or healthcare provider to determine if a treatment extension is necessary and to understand the specific requirements for submitting such a request.

What is Psychology treatment extension request - C1147 Form?

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A psychology treatment extension request is a formal request submitted to extend the duration of mental health treatment or therapy due to ongoing needs.
Patients currently undergoing psychological treatment who require additional time for their therapy sessions are typically required to file this request.
To fill out a psychology treatment extension request, patients must provide their personal information, the details of their current treatment, the reason for the extension, and any supporting documentation required by their mental health provider.
The purpose of a psychology treatment extension request is to formally inform the mental health provider about the need for continued therapy and ensure that the patient's treatment is not interrupted.
Information that must be reported includes the patient’s name, contact details, current treatment plan, reason for extension, and any relevant medical or therapy records.
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